Prosthetic advances.

Much of the current prosthetic technology is based on developments that have taken place during or directly following times of war. These developments have evolved and improved over the years, and now there are many more available options to provide a comfortable, cosmetic, and highly functional prosthesis. Even so, problems with fit and function persist. Recent developments have addressed some of the limitations faced by some military amputees. On-board microprocessor-controlled joints are making prosthetic arms and legs more responsive to environmental barriers and easier to control by the user. Advances in surgical techniques will allow more intuitive control and secure attachment to the prosthesis. As surgical techniques progress and permeate into standard practice, more sophisticated powered prosthetic devices will become commonplace, helping to restore neuromuscular loss of function. Prognoses following amputation will certainly rise, factoring into the surgeon's decision to attempt to save a limb versus perform an amputation.

Advanced rehabilitation techniques for the multi-limb amputee.

Advances in combat casualty care have contributed to unprecedented survival rates of battlefield injuries, challenging the field of rehabilitation to help injured service members achieve maximal functional recovery and independence. Nowhere is this better illustrated than in the care of the multiple-limb amputee. Specialized medical, surgical, and rehabilitative interventions are needed to optimize the care of this unique patient population. This article describes lessons learned at Walter Reed National Military Medical Center Bethesda in providing advanced therapy and prosthetics for combat casualties, but provides guidelines for all providers involved in the care of individuals with amputation.